Dr. A. T. Still Founder of Osteopathy
M. A. Lane
OSTEOPATHY IN INFLAMMATORY DISEASES
To Dr. A. T. Still, founder of osteopathy, belongs much if not most of the credit
for the modern recognition of the fact that inflammations are, in reality, not
diseases in themselves, but the results of the body's attempt to kill and cast
out the harmful germs which, when they enter the body that is not sufficiently
protected against them, produce what has been called "disease". In the preceding
chapter we discussed the nature, effects and causes of infectious diseases, and
related how osteopathy can and does not only change and relieve these diseases,
but also cures them - that is, reduces their active effects to zero.
In former times inflammations were themselves regarded as diseases, and naturally
enough, when one considers how very little was known concerning them. All true
inflammations consist, according to the ancient definition of these peculiar
changes in the tissues, of redness, swelling, heat and a certain amount of pain
or discomfort. These were regarded as the "four cardinal signs" of an inflammation.
The inflamed part became red, it was swollen as compared with the normal state,
it was hotter (fever) than in the normal state, and there was always pain -
great or small as the case may be. Now in so far as the inflammation was regarded
as a disease - the effort of the old style medicine (the healing art) was naturally
directed against the inflammation (not against the cause of it) - it was deemed
desirable to stop the inflammation or "reduce" it, at the same time reducing
the fever that accompanied it. It had been found that if blood in generous quantities
be withdrawn from the veins, the fever in a diseased body would be reduced.
Therefore, it was believed that bleeding was a good remedy against inflammation
and it was commonly practiced by all the old doctors. The professors of the
healing art gave up their old method of bleeding only after a most bitter fight.
But even after exhaustively bleeding the patient had been abandoned as a therapy,
it was still believed that it was the inflammation that constituted the essentials
of the disease. In recent years, however, this belief has vanished, and the
intelligent doctor of today knows that an inflammation, wherever found, is only
the reaction of the body against the invading germs, or other destructive agents.
WHY INFLAMMATION CAUSES PAIN
Why? Because inflammation primarily consists of an unusual quantity of blood
being drawn to the part. Hence, the heat, the swelling, the redness and the
pain; for the unusual swelling of the inflamed part causes pressure on the delicate
nerve endings in the part, and this pressure causes pain.
Now when this unusual quantity of blood in the engorged and enlarged blood
vessels of the part flows back into the general circulation, and the lymph that
has exuded from the engorged blood vessels into the tissues of the inflamed
part flows out into the lymph vessels - all signs of the inflammation disappear
and the part has been restored to its normal condition.
Nature accomplishes this reaction in ways peculiar to the peculiar pathogenic
germ that is causing the trouble. Sometimes pus is formed, as in boils or carbuncles;
sometimes fibrin is formed, as in pneumonia, diphtheria, and other fibrin-forming
inflammations; but whatever the peculiar reaction may be, it is always based
on the principle that the blood and the cells of the blood and of other tissues
aim first to counteract, destroy and remove the direct causes that are destroying
the tissues. And when this has been done, repair of the destroyed parts naturally
follows. All these facts are now well known to pathologists, but such knowledge
is of comparatively recent growth, and there is no therapy that is based on
these facts so firmly and scientifically as osteopathy.
DR. STILL EARLY PERCEIVED THAT THE BLOOD CURES
To A. T. Still belongs the credit for having been one of the first, if not
the very first, to perceive the great natural laws that underlie the facts as
we write them. For what was Dr. Still's argument? It was this: Nature to cure
the "disease" sent blood in unusual quantity to the part, thus producing an
inflammation. When, now, the cure had been worked out by the inflammation, the
symptoms subsided (that is the inflammation) and the tissue became nearer normal,
if not quite so. But since this is nature's own way of curing, the use of any
method which would send blood into the part, in greater quantity than nature
itself could send it into the part, would assist nature and hasten the cure,
or actually initiate a cure, where, if left alone, nature would never of itself
be capable of sending in enough blood to do the business, with disaster or death
in prospect as a. consequence.
Osteopathy, therefore, teaches that an inflammation is nature's own method of
curing certain diseases called infections; and it further teaches that by artificially
increasing the quantity of blood flowing into an infected place, natural results
can be obtained in greater quantity, and much more quickly, than unassisted
nature herself can obtain them. This teaching, from the standpoint of pure science,
as this subject has been illuminated in recent years, is scientifically unassailable
and it works!
But osteopathy does more than increase the inflammatory reaction of the blood
in infections. We say that it must do more, otherwise there could be no really
scientific way of accounting for the peculiar results which are the common experience
of osteopathic treatment in certain infectious diseases as the grip, pneumonia
and typhoid fever, when the poisons (toxins) made by the germs are diffused
throughout all the circulation, and hence through all the tissues of the body.
Let us glance at a common infection that produces an inflammation typical of
the pathogenic germ involved, and also typical of the location in the body where
the germs are growing. This infection is known as furuncle or in common language
boils. What is a boil? It used to be believed by the old doctors (and is still
believed by the uniformed) that boils were an indication of "impurity of the
blood" and that this "badness" or "impurity of the blood", was "coming out"
in the boils. Hence the old school of drug doctors had certain "remedies" not
only for boils but for all other eruptions on the skin, especially eruptions
that had pus in them, and these remedies were called by the old doctors "depurants"
or remedies that cleared the blood of pus (such as sarsaparilla or other "purifiers").
THERE IS NO PUS IN THE BLOOD
In the word "depurant" the syllable "pur" is the same word as "pus", so that
depurants depusified the blood - took the pus out of the blood, according to
this delusion. The theory was that the pus which came out was originally in
the blood, else it could not come out! Now there is no pus in the blood, but
there are certainly in the blood many millions of white cells which, when they
increase in number and gather by the millions in some certain place, and are
killed by the disease germs, which they take into themselves to rid the body
of them and their poisons, form pus. Pus in reality consists chiefly of the
dead white cells (the leucocytes, phagocytes) that have lost their lives in
defending the body from the invading germs. An inflammation that forms pus is
called a purulent inflammation; and a boil, or furuncle, as it is called by
the pathologists, is one type of purulent inflammation presenting phases, or
characters, peculiar to itself because of the place where it is growing, that
is, in the skin. Boils are caused directly by the presence in the deep part
of the skin, or under the skin, of a germ called staphylococcus pyogenes aureus-staphylococcus,
because the little spherical germs grow in the form of bunches; pyogenes because
this germ draws to the neighborhood in which it is multiplying the white cells
of the blood that when dead form pus; and aureus because the colonies of the
germ, when grown in pure cultures outside the body on a medium such as gelatin,
or agar, in a test tube or other vessel, are golden in color, aureus meaning
"golden" and nothing else. There are several different varieties of staphylococci,
but this particular one is the most commonly concerned. Now this germ enters
the body by passing down the microscopic space surrounding a hair. The individual
germs are so small as to be distinctly visible only under very high powers of
the microscope, say a magnification of about I,OOU diameters of the object itself.
The individual germ is scarcely larger than about 1-25000 of an inch-a size
so small as to surpass the power of the imagination. It can therefore have an
easy passage in the smallest crevices, or chinks, or holes in the skin, and
it actually makes its way into the deeper parts of the skin in this way.
Once in it finds itself surrounded by the richly nourishing fluid that nourishes
the skin - the so-called lymph of the body, that passes out through the walls
of the tiny capillaries that convey the blood to the remotest corners of the
tissues. Here the germ finds a "medium" of growth and nourishment finer and
richer than any artificial medium the bacteriologist can make in his laboratory,
and the staphylococcus begins to multiply! In multiplying it throws off from
its inconceivably minute body the excretions of its life growth, and these excretions
are poisonous to the tissues. But they do not diffuse easily, so that the area
of infection is more or less limited to the locality of the original entrance
point. The tissue cells die and digest themselves, and the liquid substance
produced by the auto-digestion diffuses around the place to the nearest blood
vessels and attracts to the vicinity the white cells which, when they arrive
at the spot where the germs are multiplying, ingest or engulf the bacteria and
are killed by the germs. But the germs themselves are killed in their own turn
by the white cells and in this way the pus is formed.
HOW A BOIL IS CAUSED
Meanwhile, the poisonous substances made by the bacteria and the dying tissues
have caused a powerful flow of blood to the part, by causing the calibre of
the little vessels to open out wide, letting in the blood by simple mechanical
law of hydrostatics, so that previously to the pus formation the part becomes
highly swollen, red and hot - in other words inflamed, and down through the
center of the inflamed area is a plug of yellowish solid material, the "core"
of the boil. This core consists of dead skin tissue, not yet all dissolved,
filled with white-yellowish pus cells. The boil may "break" out on the surface
of the skin - if the inflammation be rapidly formed - and with this release
of the pus the germs are also carried out of the pocket and the injury heals
rapidly leaving only a slight scar. If the development of the inflammation be
slower, however, the "core" is formed, the subsequent repair is slower also,
and the scar will be larger and deeper. But it is clear from what has been said
that the more rapidly formed the inflammation, the more rapid will be the healing
process. And the rapidity of the entire proceeding will be determined largely
by the quantity of blood drawn to the part in the beginning of the infection.
Now if osteopathic treatment be given for a boil at the beginning of the inflammation,
the excessive quantity of blood, over and above the natural quantity which is
sent into the part by the treatment, will hasten the inflammation in an artificial
way, and hence such an infection can be shortened in its course by just that
much. And this has occurred in the treatment of boils by osteopathy.
HOW THE BLOOD WORKS ITS CURE
We can partly explain these interesting facts in this way: A certain amount
of blood is needed to neutralize the poisons and destroy the life of a certain
number of germs in the tissues. If these germs did not multiply in number a
given quantity of blood would do the work in a given time. But the number of
germs is constantly growing, and inasmuch as nature itself can supply only a
limited amount of blood in a given time, the inflammation must grow larger as
the number of germs increase, and it must grow larger at a higher rate than
the rate at which the number or germs grows; else the multiplication of the
germs could never be stopped. The entire time required by nature to do the work
is generally - when the germs are growing in the skin - about ten days; after
which the inflammation subsides because the germs have been almost all killed.
But it can be seen that if the rate at which the blood flows into the part be
increased beyond the natural rate, the inflammation, just because it is increased
out of its natural proportion, should be correspondingly shortened; and this
is the actual fact.
But it would appear from this that there must be something in the blood that
kills the germs. What is this thing?
To answer this question we must direct the attention of the reader to certain
substances in the blood called opsonins by their discoverer, Sir Almroth E.
Wright, of London. Opsonins are substances in the blood which have a chemical
affinity for bacteria-the germs of disease-including staphylococcus pyogenes
aureus. These substances unite with the bacteria so that the white cells can
engulf them, thus killing them and removing them from the tissues and forming
pus. If the blood of an individual be rich in the opsonin against this particular
germ that causes boils, the few germs that enter the skin, or under it, are
at once changed by their union with this special opsonin and the bacteria are
now engulfed by the leucocytes.
The presence in the blood of these peculiar substances called opsonins, and
their action in the way described, constitutes the immunity of the individual
against the special germs against which the opsonins are directed. Upon these
facts is based the great phagocytic theory of immunity, originated by the late
Professor Elie Metchnikoff, of Paris, who died recently, and who has always
been regarded by osteopaths with a certain reverence as having in a considerable
degree explained by scientific experiments the remarkable effects of osteopathic
treatment in certain infectious diseases. Osteopaths have also had much respect
and admiration for Sir Almroth E. Wright, the Englishman who discovered and
proved the presence in the blood of the opsonins, and thus entirely vindicated
the original work of the great and powerful Metchnikoff. For the osteopath can
see clearly how a local infection such as boils, if we assume the presence in
the blood of the opsonin bodies (which are as truly "antibodies" as are the
other antibodies so widely discussed today), can be abated and cured by causing
the blood in larger quantities (and hence the opsonins in the larger quantities)
to flow through the infected part.
There is another interesting fact about the results of osteopathic treatment
in the case of boils, when the osteopathic doctor attacks this disease in time,
that is, early after the appearance of the first redness and swelling.
Almost invariably whenever a boil appears it is followed by several new ones.
Boils as a general rule come in crops. Why is this the fact? Because when the
germ-containing pus breaks out on the skin, the germs are smeared over the unaffected
skin, and some of these germs, being still alive and virulent, make their way
into the skin, or under it, through the spaces alongside of the hairs of the
skin - just a repetition of the original infection. This spread of the infection
will go on until the skin, all around the original site of the infection, has
become immune by the natural production of the anti-staphylococcic opsonin.
The entire infection will now clear up-if the individual's body can make the
opsonsin in sufficient quantity. When the reverse is true we have what is called
WHY OSTEOPATHY PREVENTS A SECOND CROP
But if the patient has had osteopathic treatment in time, if blood has been
thrown in liberal quantities into the part, the excess of the specific opsonin
thrown into the blood causes, apparently, a certain peculiar change in the germs
by which they are rendered less virulent, or more easily and quickly engulfed
by the soldier cells of the blood, and hence when the original boil breaks,
and these germs now enter the skin alongside the hairs, the germs are quickly
disposed of by the phagocytes of Metchnikoff, and no second boil appears. The
infection does not spread. These things occur also when the patient, for one
or another reason, has been taking osteopathic treatment, and becomes infected
by this peculiar germ. Only one boil appears and its course is quickly and mildly
run, with comparatively little pain and no re-infection. Only one explanation
of these peculiar facts can be given, and that is that osteopathic treatment
not only makes full use of the quantity of opsonin naturally in the body, but
also actually increases the total quantity of this opsonin naturally circulating
in the blood.
HEALTHFUL BLOOD NATURE'S BEST GERMICIDE
Now this is the very result which Sir Almroth E. Wright has attempted to produce
by his so-called vaccines, or dead staphylococci, which he injects into the
blood of the patient suffering with boils, after having grown them from germs
taken from the patient's own lesions. The world's bacteriologists and immunologists
all agree in the verdict that Wright's claims must be exaggerated, for no one
but Wright himself has been able to secure the results claimed by him. It is
highly significant that osteopathy here, as elsewhere in the infectious diseases,
seems quite competent to do the very things which the vaccine therapy theoretically
should be able to do and cannot. It is not to be argued from this that Sir Almroth
E. Wright is wrong in his experiments with the opsonins, for he certainly has
made a prime discovery which, theoretically should be able to work cures in
infections from these peculiar germs, but which fails in all but a comparatively
few cases. Neither Wright nor any other scientific investigator (outside
of the osteopaths) has tried the effect on the work of opsonins by flushing
the parts with larger quantities of natural blood than the normal inflammation
contains. Osteopathy, by washing the inflamed part with increasing streams of
normal blood actually brings larger supplies of normal opsonin to the part than
could possibly flow to it normally; but it is also more than probable that the
total amount of this antibody is increased by the treatment.
Somewhat similar phenomena appear when virulent tonsillitis is treated at the
beginning of the infection by thorough osteopathic manipulation. That the virulence
of bacteria (germs) can be sensibly lessened, and even quite destroyed, by osteopathic
treatment, need not be doubted today ; and the time is not far away when scientific
research will clear up much of the mystery that now puzzles osteopaths in the
results they secure in the treatment of infectious diseases.
Tonsillitis in varying degrees of virulence can be caused by several entirely
different germs, but typical painfully virulent tonsillitis, accompanied by
systemic fever, is nearly always (la grippe aside) due to the growth in the
tonsils of a pus-making germ called streptococcus pyogenes (streptococcus because
the germs grow in the form of chains).
Not long ago a culture of streptococcus pyogenes was made from the throat of
a child who had an intense inflammation of the tonsil accompanied by high temperature.
The parents of the child had called in an osteopath at the very first appearance
of the attack. The temperature (fever) was marked and the tonsil typical. But
the osteopath (fortunately for the child if unfortunately for the experiment)
had given the patient two thorough treatments before taking the "swab" from
the throat. After the first treatment the fever had reduced almost to normal,
and after the subsequent treatment the tonsils had been distinctly relieved
and the fever almost all removed. The germs were still there in quantity, but
when their virulence was tried out in a laboratory experiment, the germs were
found to be quite harmless. Now it is only rational to conclude that the treatment
had directly to do with the destruction of the virulence of this germ, for such
a tonsillitis - if let alone - would normally run its usual course, and recovery
take place only after the body had immunized itself against the germ by an increase
in the anti-streptococcic bodies in the blood. Theoretically a vaccine should
do what this osteopath did, but practically such a result is rare in vaccine
therapy. The laws underlying these remarkable results of osteopathic treatment
will certainly some day be established by scientific osteopathic research, but
in the meantime the osteopathic practitioner can, in the interest of his patients,
assume that his own theory of results is ample to account for them, and go on
treating infectious diseases in the proved conviction that his peculiar form
of mechano-therapy as worked out by Dr. A. T. Still actually and practically
does what serum and vaccine therapy should invariably do but unfortunately does
One of the most remarkable results in the osteopathic treatment of infections,
familiar from of old to all practitioners and even students of this art, is
the result in acute and chronic dysentery. Dysentery (diarrhoea) is most frequently
caused by the growth in the intestine of one of the several types of germs producing
the typical flux from the intestine. Pressure on the spine (in a way peculiar
to osteopathic theory and practice) quickly stops dysentery when caused by these
germs. The treatment is familiarly known to osteopathic doctors as "inhibition".
Dr. A. T. Still early demonstrated the entire curability of dysentery by this
method in quickly restoring to normal a number of children afflicted in this
way. His early success has been followed up ever since that time by the members
of his school who have come to regard this kind of dysentery as a simple matter
for the osteopath to cure.
DRUGS DO NOT ACT LIKE OSTEOPATHY
What is the drug treatment for dysentery? There are two methods opposite in
theory and practice. One is to clean out the intestine with a purgative, the
other is to paralyze the intestine by drugs such as chloroform. Capsicum (red
pepper) and chloroform will often suddenly stop the movement of the intestines
in dysentery, but never as quickly as osteopathic inhibition. The chloroform
may act as an inhibition of the growth of the germs, but this inhibition is
not at all what is meant by the osteopath when he uses that word. Osteopathic
inhibition is temporary stoppage of the movement of the intestine, and this
stoppage is entirely free from the after effect which follows the use of the
drug. Permanent recovery quickly ensues, and in some way the multiplication
of the germs in the intestine is stopped. Possibly this growth is stopped by
the accumulation of their own secretion products in the intestine, but more
probably by the production in the blood of the intestines of substances that
escaping into the intestines do the damage to the germs there. It is difficult
to account for the results of osteopathic treatment in dysentery unless some
back bone lesion is assumed to exist even where it is invisible; but the certainty
of the results is one of the most remarkable and interesting of the innumerable
interesting facts of the osteopathic therapy.
INCREASING THE BODY'S RESISTANCE
When we say that osteopathic treatment reduces the virulence of disease germs,
we can only mean one thing, and that is that osteopathic treatment increases
the body's resistance to the germs in question once the germs are in and multiplying.
No definite experimental proof has ever been established that the body's resistance
to disease germs can be increased by osteopathic treatment before an infection
is introduced into the body. That is to say, it has not yet been experimentally
proved that osteopathic treatment can so increase the body's resistance to all
germs that this treatment can be absolutely regarded as a preventative of infection,
as for example when vaccine for typhoid fever prevents the individual treated
from acquiring typhoid fever. And yet, pending such experimental evidence, the
osteopath is warranted in assuming that general osteopathic treatment actually
does accomplish some such body change, for we know as a matter of fact that
osteopathic treatment vastly increases those normal reactions of the body which
are, in fundamental physiology, physiologically similar to the body's reactions
against infectious germs and their toxins.
WHY OSTEOPATHY REFRESHES AFTER FATIGUE
For example, an osteopathic treatment when one is tired and exhausted after
a day's hard work will wonderfully refresh the body and restore its vigor, producing
a physiological reaction very nearly equivalent to a good night's sleep. This
is a fact familiar to all osteopaths, many of whom are eager to get such a treatment
for themselves whenever a friendly fellow practitioner is near by and agreeable.
Now what does this reaction mean? If it means anything it means that the osteopathic
manipulation of the spine actually does what sleep will do for a similarly tired
man. And sleep, it is known, refreshes and strengthens the body in all its parts,
and in all its cells, by neutralizing the poisons released by the work of the
body's cells in their activities during the waking state. The nerve cells, the
muscle cells and all the other cells (but principally these two master tissues)
work, and in working throw out of themselves into the blood stream certain chemical
waste substances which react on the nerve cells as toxins - the toxins of fatigue.
During sleep the body cells manufacture antibodies that neutralize the fatigue
toxins, and the nerve cells therefore feel fresh again. Simple feeding of the
nerve cells is not sufficient. These fatigue substances must be neutralized
and several hours are necessary to do it - hours during which no further fatigue
toxins are made by muscle and nerve. But osteopathic treatment will encompass
after 30 minutes what otherwise requires several hours of sleep. Thus does osteopathic
treatment stimulate the body to the rapid production of antibodies against normal
toxins made by the normal activities of the normal boy's cells.
Now the toxins of disease are toxins not made by the body's own cells, but
by the foreign cells called disease germs, and it is reasonable to say that
the effect of osteopathic treatment on the normally tired body is regulated
by the same physiological law that underlies the production of antibodies to
the toxins of disease.